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Application and Enrollment

We offer several different electronic application methods that can be used to compliantly submit an application and record credit for the enrollment to the broker of record.

Personalized URL (PURL)

A PURL is a non-broker-assisted, online application tool where beneficiaries can self-enroll within your book of business. The PURL is available/emailed to active certified brokers just 7-10 days after all certification requirements are successfully completed. A PURL is assigned to a broker using the following format for MAPD and PDP lines of business:

Brokers have the flexibility to market their PURL to Medicare beneficiaries via the following:

  • Business card
  • Flyer
  • Website
  • Social Media pages

By utilizing the PURL, beneficiaries have access to a plan compare tool that will provide an overview of each benefit available in their market. Once the plan selection is made, the beneficiary can continue with the online application.

After submission and processing, the broker will receive credit for the enrollment. Commissions will reflect on your statement in the Agent Connect portal.

Note: Broker cannot complete the online application on behalf of the beneficiary, or assist the beneficiary with completion of the application via the PURL.

Electronic Application

The broker-assisted electronic applications are a secured, compliant method for enrolling a beneficiary in a plan. We offer three different electronic applications at no cost to the broker:

Ascend – desktop, iOS, and Windows:

Ascend is a secure, encrypted, real-time cloud-enabled data platform that brings together all necessary tools for field sales agents to have meaningful engagements with prospective members.

There are many advantages to using Ascend:

  • One platform for all plans we offer with the ability to compare plans
  • Electronic Scope of Appointment
  • Quick-Quote: a fast application tool that pre-fills
  • RATE: A telephonic enrollment tool
  • Recorded Meetings: Allows a call to be recorded and stored
  • Blue Button integration with CMS
  • Integrated and always up-to-date PCP search tool
  • Automated Verification Capability: including Medicaid, LIS, and Medicare
  • Ascend is our primary enrollment method

Access Ascend Real-Time Manager here! Once logged in, you can download the mobile app for iOS or Windows.

Download our helpful user guide (PDF)!

Paper Application Submission

Brokers must compliantly document scope of appointment (SOA) on a paper SOA form prior to enrollment through a paper application. Brokers are required to submit paper applications through one of the following:

  • Agent Connect Portal by attaching the application to a Support Ticket and selecting “New Enrollment Submission” as the ticket subject line
  • Fax both the SOA and application to the MAPD line at 866-473-9124 or the PDP line at 866-388-1521

Click the tabs under Important Information to expand details related to application and enrollment, formularies and Fidelis Care points of contact!